Pulmonary Vein Isolation in Typical Atrial Flutter and Heart Failure

Inclusion Criteria: * Aged 18 to 80 years * Typical AFL referring for ablation * No prior history of AF * Fulfilling the criteria for HF: New York Heart Association (NYHA) function class II or greater; and N-terminal pro-brain natriuretic peptide (NT-pro-BNP) \>125 pg/ml in sinus rhythm or \>365 pg/ml in AFL * Optimized guideline-directed medical therapy for HF for at least one month * A minimum of anticoagulation for three weeks * Sign informed consent Exclusion Criteria: * Any AF episodes documented during 48-hour Holter monitoring * Presence of left atrial thrombus * HF due to infiltrative cardiomyopathy, constrictive pericarditis, active myocarditis, cardiac tamponade, or uncorrected primary valvular disease * Acute coronary syndrome, cardiac surgery, angioplasty, or cerebrovascular accident within three months prior to enrollment * Previous cardiac transplantation, complex congenital heart disease, rheumatic heart disease * Untreated hypothyroidism or hyperthyroidism * Dialysis-dependent terminal renal failure * Life expectancy \<12 months due to non-cardiovascular causes. * Any conditions that, in the opinion of the investigator, may render the patient unable to complete the study * Female under pregnancy or breast-feeding * Involved in other studies